Abstract
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Objectives Angiogenesis is considered critical for atherosclerotic plaque (AP) progression and may promote plaque vulnerability. Vascular 18FDG uptake can detect plaque inflammation and has been used as a surrogate to quantify vulnerable plaque burden. Vascular endothelial growth factor (VEGF) inhibitors can effectively attenuate angiogenesis. We investigated the effect of VEGF-inhibitors on aortic plaque inflammation using 18FDG PET/CT imaging.
Methods This is a retrospective study of 58 patients who underwent whole body 18FDG PET/CT in 2009 at a single center. Aortic AP 18FDG uptake was measured in four segments (ascending, arch, descending and abdominal). Mean standard uptake value of the vessel wall expressed as target-to-background ratio (TBR) was quantified in 19 patients who received a VEGF inhibitor and 38 controls. Groups were matched for age, gender and high cardiovascular risk. Data was analyzed with SPSS software.
Results Among the 58 patients identified (45 female, age 45 ± 9.4 years, body mass index (BMI) 29.98 ± 5.08 kg/m2), and after accounting for BMI, radiation therapy and concomitant use of statins, aspirin or clopidogrel, VEGF inhibitor was independently associated with decreased aortic 18FDG uptake (β = -0.029, P<0.05, CI: -0.002—0.057). Increase in BMI was associated with increased aortic 18FDG uptake (β = 0.003, P<0.05, CI: 0.00-0.006).
Conclusions VEGF inhibition of angiogenesis may reduce inflammation of aortic plaque as measured by 18FDG-PET/CT. Targeting angiogenesis with medical therapy may attenuate progression of atherosclerosis.